Flashcards in Section 9 (Chapters 35-39) Deck (44):
Number of workers to supervisors in Span of Control.
no more than 7
NIMS Control Section
Incident Commander IC
Public Information Officer PIO
NIMS Finance Section
Tracks all expenditures during an incident
NIMS Logistics Section
NIMS Operations Section
Tactical operations on larger incidents
Develops action plan
Solves problems as they arise
Medical Incident Command Functions
Rehabilitation (rest/recovery of responders)
Extraction and Special Rescue
Mass Casualty Incicent (MCI)
Immediate (RED) S/S shock or head injury
Delayed (YELLOW) non-immediate treatment/transport
Minor (Green) walking wounded
Dead/Dying (Black) already dead or low chance of survival - only treat after all others
Simple Triage and Rapid Treatment (START)
Direct all patients capable of moving to central location. These are walking wounded and get GREEN tag.
Respiration - if not breathing manually open airway. Does not start breathing spontaneously, BLACK tag.
If patient begins to breathe, RED tag, put in recovery position, move on to next patient.
If patient breathing spontaneously >30 or <10 keep RED tag.
If breathing spontaneously 10-30 check perfusion.
Perfusion - Assess radial pulse. If absent, keep RED tag.
If pulse is present, check Mental status.
Mental status - Does patient follow simple commands? If no, keep RED and move to next patient. If yes, change tag to YELLOW and move on to next patient.
Special needs patients such as children where START result is not clear, should be moved to secondary triage as soon as possible.
Primary blast injury - caused by blast
Secondary blast injury - caused by flying debris
Tertiary blast injury - caused by patient striking ground or other object.
Signs and symptoms of nerve agent exposure.
Management includes aggressive airway management including suction and ventilatory support.
ricin, sarin, soman, tabun, VX
Signs and symptoms of vesicant exposure.
pain, burns and blisters to exposed skin, eyes and respiratory tract.
Irrigate affected areas with copious amounts of water.
Lewisite, phosgene oxime (CX), sulfur mustard (garlic smell)
Signs and symptoms of cyanide exposure.
dizziness, weakness, anxiety, nausea, tachypnea, seizures, respiratory arrest.
Manage with high flow oxygen, positive-pressure ventilation may be needed.
Signs and symptoms of pulmonary agents.
dyspnea, cough, wheezing, runny nose, sore throat.
Manage airway, administer oxygen, support ventilation.
Signs and symptoms of biological agents.
fever, weakness, respiratory distress, flu-like symptoms.
Provide supportive care.
Bubonic plague, pneumonic palgue, botulism
Types of nuclear radiation.
Alpha - travels short distances, stopped by clothing, skin, etc.
Beta - travels a short distance, penetrates only the 1st few mm of skin.
Gamma (XRay) - travels long distances and easily penetrates body. Significant external hazard to humans.
Neutrons - easily penetrates through lead and requires several feet of concrete.
Limitations of exposure include Time, Distance, and Shielding.
Signs and symptoms of acute radiation sickness.
nausea, vomiting, diarrhea, fever, headache, skin lesions.
Disease caused by deadly bacteria that lay dormant in a spore; germ is released from spore when exposed to optimal temperature and moisture. Inhalation, cutaneous and GI (from food containing spores)
Types of weapons of mass destruction.
Toxin produced by bacteria; potent neurotoxin. Affects nervous system ability to function.
Epidemic Black Death (Middle Ages)
Transmitted by infected fleas and characterized by acute malaise, fever, formation of tender, enlarged, inflamed lymph nodes (Buboes).
Animal that spreads disease.
Early nerve agents (sarin, soman, tabun)
Highly contagious disease. Most contagious when blisters form.
Patient is dragged or pulled from a dangerous scene before assessment and care are provided.
If a patient has an altered LOC, inadequate ventilation, or shock, or in extreme weather conditions.
If patient is in car, use rapid extraction technique.
Stabilize neck manually; second moves legs to opposite side of car in small, coordinated movements. third supports back and slides long board against seat. Patient is lowered with head supported onto board and slid until completely on board. Patient secured and patient is transported to safe area to continue care.
When you can use Rapid Extraction Technique.
Vehicle or scene is unsafe.
Explosives or other hazards at scene.
Fire or danger of fire.
Patient can not be properly assessed where they are.
Patient needs immediate intervention that requires supine.
Patient has life-threatening condition which requires immediate transport to hospital.
Patient is blocking access to another seriously injured person.
Questions to ask before lifting a patient.
Am I physically strong enough to lift/move this patient?
Is there adequate room to get into the proper stance before I lift the patient?
Do I need additional personnel for lifting assistance?
Phases of an ambulance call.
Preparation for the call
Arrival at scene
Transfer of patient to ambulance
En route to receiving facility
At receiving facility
En route to station
How many mm Hg of vacuum should a suction unit have?
300 mm Hg
What is the first rule of driving an emergency vehicle?
Speed does not save lives; good care does.
At what speed can hydroplaning occur?
At speeds greater than 30 mph
When you are using lights and siren, from which usual rules may you be exempt?
Park or stand in an otherwise illegal location; proceed through a red light or stop sign; drive faster than the posted speed limit; drive against the flow of traffic in a one-way street; make a turn that is normally illegal; travel left of center to make an otherwise illegal pass.
What is extrication?
Extrication is the removal of a patient from entrapment or a dangerous situation or position, such as removal from a wrecked vehicle, industrial accident, or building collapse.
What is JumpSTART triage procedure for pediatric evaluation?
The JumpSTART triage system reminds us that children are not little adults. The most common cause of cardiac arrest in pediatric patients is respiratory arrest, and the respiratory assessment was designed around this fact. If you come upon a pediatric patient who meets the JumpSTART triage criteria and is not breathing, immediately check for a pulse. If there is no pulse present, label the patient as expectant. If the child is not breathing but has a pulse, open the airway using the appropriate method. If there is no respiratory effort noted, deliver five rescue breaths and reassess for spontaneous breathing. A continued absence of spontaneous respirations should lead you to tag the child expectant.
When no hazards and no life-threatening conditions exist.
Direct ground lift, extremity lift, direct carry, draw sheet.
When patient has life threatening injuries and must be moved quickly for evaluation and transport.
Rapid extraction is an urgent move from a motor vehicle; multiple rescuers and a long board.
When scene is unsafe and patient must be moved before providing patient care.
Includes armpit-forearm drag, shirt drag, blanket drag.
What does the mnemonic DOPE stand for in artificial airway management?
Displacement, dislodged, or damaged tube
Obstruction of the tube (secretions, blood, mucus, vomitus)
Pneumothorax, pulmonary problems
Equipment failure (kinked tubing, ventilator malfunction, empty oxygen supply)
Characteristics of HazMat Placard.
Blue diamond - health hazards.
Red diamond - fire hazards.
Yellow diamond - reactivity hazards.
White diamond - symbols of special hazards.
Higher numbers in blue, red and yellow denote greater hazards.
What are immediate patients (red tagged)?
Primary assessment problems or head injury or shock.
What are delayed patients (yellow tagged)?
Require treatment and transport, but not immediate.
What are minor patients (green tagged)